Provider Demographics
NPI:1497822944
Name:AHALT, LOUIS FRANKLIN JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:FRANKLIN
Last Name:AHALT
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 OPAL CT
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5940
Mailing Address - Country:US
Mailing Address - Phone:301-790-1560
Mailing Address - Fax:301-790-1666
Practice Address - Street 1:1140 OPAL CT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5940
Practice Address - Country:US
Practice Address - Phone:301-790-1560
Practice Address - Fax:301-790-1666
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD049861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
002860OtherVALUE OPTIONS PROVIDER NO
MD325085OtherM.D. IPA PIN
MD100027640001OtherAPS HEALTHCARE PIN
MDR036 0001OtherCAREFIRST BCBS FEP PIN
MD7680030OtherAETNA PIN
MD325085OtherM.D. IPA PIN
MDQV30Medicare UPIN
MDQV30Medicare UPIN